Association Of Stressful Life Events Research Articles

Stress, Resilience, and Cardiovascular Disease Risk Among Black Women

Empirical data on the link between stress and cardiovascular disease (CVD) risk among black women is limited. We examined associations of stressful life events and social strain with incident CVD among black women and tested for effect modification by resilience. Our analysis included 10 785 black women enrolled in the Women's Health Initiative Observational Study and Clinical Trials cohort. Participants were followed for CVD for up to 23 years (mean, 12.5). Multivariable Cox regression was used to estimate hazard ratios and 95% CIs for associations between stress-related exposures and incident CVD. We included interactions between follow-up time (age) and stressful life events because of evidence of nonproportional hazards. Effect modification by resilience was examined in the sub-cohort of 2765 women with resilience and stressful life events measures. Higher stressful life events were associated with incident CVD at ages 55 (hazard ratio for highest versus lowest quartile=1.80; 95% CI, 1.27-2.54) and 65 (hazard ratio for highest versus lowest quartile=1.40; 95% CI, 1.16-1.68), but not at older ages. Adjustment for CVD risk factors attenuated these associations. Similar associations were observed for social strain. In the sub-cohort of women with updated stressful life events and resilience measures, higher stressful life events were associated with incident CVD in multivariable-adjusted models (hazard ratio=1.61; 95% CI, 1.04-2.51). Resilience did not modify this association nor was resilience independently associated with incident CVD. In this cohort of older black women, recent reports of stressful life events were related to incident CVD. Resilience was unrelated to incident CVD. URL: https://www.clinicaltrials.gov . Unique identifier: NCT00000611.

Growing Resilience through Interaction with Nature: Can Group Walks in Nature Buffer the Effects of Stressful Life Events on Mental Health?

Nature-based activities have been used as therapeutic interventions for those experiencing stress and mental ill health. This study investigates whether group walks could be a nature-based intervention to foster resilience, by buffering the effects of recent stressful life events on mental health. An observational research design with propensity score-matched samples compared the mental health of individuals who did (Nature Group Walkers, n = 1081) or did not (Non-Group Walkers, n = 435) attend nature group walks. A sub-sample of Frequent Nature Group Walkers (at least once per week, n = 631) was also investigated. Data were analyzed using multiple regression with an interaction term. All analyses were controlled for age, gender, and recent physical activity. Results showed that neither nature group walking, nor doing this frequently, moderated the effects of stressful life events on mental health. Using a main effects model, the positive associations of group walks in nature were at a greater magnitude than the negative associations of stressful life events on depression, positive affect, and mental well-being, suggesting an ‘undoing’ effect of nature group walks. Group walking schemes in natural environments may be an important public health promotion intervention for mental health.

Correction: Krysinska, K. et al. Does Religion/Spirituality Modify the Association of Stressful Life Events and Suicidal Ideation in Australian Men? Religions 9 (2018): 180

The authors wish to make the following corrections to (Krysinska et al [...]

Stress-full life events and multiple sclerosis: A population-based incident case-control study

AimWhile sizeable evidence regarding the association between stressful-life events and multiple sclerosis (MS) disease activity (clinical and/or radiological) was previously documented, their relation to MS risk is controversial. We aimed to investigate the possible association of stressful-life events and multiple sclerosis risk after adjustment for relevant confounders in an Iranian population. MethodThis was a population-based incident case-control study that recruited 547 MS cases and 1057 healthy controls between August 2013 and February 2015, Tehran. The patients were identified using the Iranian MS Society based on 2010 McDonald criteria. We used standard random digit dialing protocol for control selection. Logistic regression model was applied to estimate the odds ratios (95% CI) adjusted for physical activity, age, gender, tobacco smoking, waterpipe smoking and passive smoking. ResultsWhile total life events number was not associated with risk of MS, homeless periods OR 3.85 (1.65–8.90), p = 0.002 as well as divorce OR 2.11 (1.24–3.58), p = 0.005 increased the risk of MS. However, marriage OR 0.59 (0.41–0.86), p = 0.006, death of ones' dear OR 0.60 (0.44–0.82), p = 0.002 and joblessness OR 0.61 (0.41–0.91) reduced the risk of MS. ConclusionWe could not detect a statistically significant role for the total stressful life event during the last 3 years and MS diagnosis. However, there is some evidence confirming the possible role of some individual life events, i.e. divorce and periods of homelessness as potential risk factors for MS and conversely, having married as a protective factor in MS onset.

Does Religion/Spirituality Modify the Association of Stressful Life Events and Suicidal Ideation in Australian Men?

In a large population cohort of Australian men, we previously observed that stressful life events were associated with increased suicidal ideation (SI). Many stressful life events, such as relationship breakdown and financial difficulties, occur frequently, yet most men who experience them do not have suicidal thoughts. There is some evidence that religious belief may be protective against suicidal behaviour. This study examined if attendance of religious service and/or perceived importance of religion/spirituality to participants modifies the association between stressful life events and suicidal thinking. Our analysis included 10,588 men who were aged 18 years or older who participated in the Australian Longitudinal Study on Male Health (Ten to Men), a national cohort study of Australian males. The study compared demographic, protective and risk factors for four subgroups: No SI, Remitted SI, New SI, and Chronic SI between Wave 1 (October 2013 to July 2014) and Wave 2 (November 2015 to May 2016) of the study and conducted logistic regression for these four outcomes. The study found a protective effect for attendance of religious services for the onset of New SI at Wave 2. Importance of religion/spirituality was positively related to Chronic SI. There were no effects of service attendance or importance for any of the other SI outcomes. We discuss results of the study in relation to social connection and broader contextual factors, such as secularization.

Appreciation of Others Buffers the Associations of Stressful Life Events with Depressive and Physical Symptoms

The current study is a cross-sectional examination of the stress-buffering effects of gratitude. Specifically, the purpose of this study was to examine whether various aspect of gratitude—appreciation of others, simple appreciation, and sense of abundance—functioned equivalently as stress-buffers and alleviated negative psychological and physical reactions to life events. One-hundred eighty-one college students completed self-report, retrospective measures of dispositional gratitude, depressive symptoms, and physical symptoms, as well as the amount of stressful life events experienced. Data were analyzed using multiple hierarchical regression. The results of the analyses revealed significant statistical interactions between appreciation of others, stressful life events, and both depressive and physical symptoms. Specifically, participants reporting a greater sense of appreciation of others also reported lower levels of depressive and physical symptoms when experiencing stress. Our results are consistent with previous research that demonstrates the protective health benefits of gratitude but highlights the importance of considering the unique aspects of the different components of gratitude.

F108. Plasma TNF-Alpha is Associated With Stressful Life Events in Youth With Bipolar Disorder

Immune dysfunction (with associated elevation in levels of inflammatory cytokines) has been implicated in Pediatric Bipolar Disorder (PBD). Early life stress has also been associated with elevated levels of proinflammatory cytokines. In the present study we evaluated the association of stressful life events and TNF-α in youths with Bipolar Spectrum Disorders (BSD).

Corrigendum to "Association of Stressful Life Events with Psychological Problems: A Large-Scale Community-Based Study Using Grouped Outcomes Latent Factor Regression with Latent Predictors".

[This corrects the article DOI: 10.1155/2017/3457103.].

Associations of stressful life events with coping strategies of 12-15-year-old Norwegian adolescents.

Successful adaptation to the environment requires strategies to cope with stressful situations. The aim of this study was to examine the role of stressful life events in coping strategies during early adolescence. A representative sample of 2464 adolescents in Norway were assessed at two time-points, one year apart (i.e., at T1, mean age 13.7years, and at T2, mean age 14.9years), with identical questionnaires. The participation rate was 88.3% at T1. Stressful life events and daily hassles were measured by questionnaires constructed for this study. Coping with stress was measured by a modified version of the Coping Inventory for Stressful Situations (CISS), which measures three coping dimensions: emotional, task and avoidance coping. Depressive symptoms were assessed by the Mood and Feelings Questionnaire (MFQ). Standard multiple linear regression methods were applied. Different domains of stressful life events were associated with the coping strategies, and these relationships differed at various time-points by gender. In sum, school stress and stressful life events in one's network (network stress) was associated with coping strategies more strongly among girls, while family and miscellaneous stress showed a stronger association among boys. These relationships were partly mediated by depressive symptom levels, more strongly in cross-sectional than in longitudinal analyses. However, daily hassles seemed to represent smaller events of no importance in coping strategies. In preventive work, reducing stressful events, treating depression and teaching healthier coping strategies are important.

Aggression and related stressful life events among Chinese adolescents living in rural areas: A cross-sectional study

BackgroundAggression is a serious problem for both individuals and society. Despite progress in aggression research, its persistence among adolescents living in rural areas remains to be investigated. We evaluate the prevalence of aggression and the association between stressful life events and aggression in a nationwide, school-based sample of adolescents living in rural areas of China. MethodsA sample of 13,495 Chinese rural students (7065 boys and 6430 girls; 11–20 years old) was selected from 15 representative rural areas from 5 provinces in China using stratified randomized cluster sampling. Aggression, stressful life events, neglect, emotional management, social support, and demographic characteristics were assessed via self-report questionnaires. Multivariate logistic regressions were used to estimate the association of stressful life events and aggression after controlling for confounds. ResultsThe prevalence of aggressive behavior among Chinese adolescents living in rural areas was 24.3%. Regression analyses indicated that the odds of aggression were negatively influenced by chronic long-term stressors related to interpersonal problems (OR=2.03, 95% CI [1.75–2.36]), health adaptation difficulties (OR=1.21, 95% CI [1.09–1.34]), and other troubles (OR=1.93, 95% CI [1.74–2.14]), even after adjustment for parental neglect, emotional management, social support, and other relevant factors. LimitationsThis study was cross-sectional; thus, it is necessary to validate the causal relationship between stressful life events and aggression via follow-up studies. ConclusionsAggression was prevalent among Chinese adolescents living in rural areas, and interpersonal problems, health adaption difficulties, and other troubles were considered potential independent risk factors for aggression.

Association of Stressful Life Events with Psychological Problems: A Large-Scale Community-Based Study Using Grouped Outcomes Latent Factor Regression with Latent Predictors.

Objective The current study is aimed at investigating the association between stressful life events and psychological problems in a large sample of Iranian adults. Method In a cross-sectional large-scale community-based study, 4763 Iranian adults, living in Isfahan, Iran, were investigated. Grouped outcomes latent factor regression on latent predictors was used for modeling the association of psychological problems (depression, anxiety, and psychological distress), measured by Hospital Anxiety and Depression Scale (HADS) and General Health Questionnaire (GHQ-12), as the grouped outcomes, and stressful life events, measured by a self-administered stressful life events (SLEs) questionnaire, as the latent predictors. Results The results showed that the personal stressors domain has significant positive association with psychological distress (β = 0.19), anxiety (β = 0.25), depression (β = 0.15), and their collective profile score (β = 0.20), with greater associations in females (β = 0.28) than in males (β = 0.13) (all P < 0.001). In addition, in the adjusted models, the regression coefficients for the association of social stressors domain and psychological problems profile score were 0.37, 0.35, and 0.46 in total sample, males, and females, respectively (P < 0.001). Conclusion Results of our study indicated that different stressors, particularly those socioeconomic related, have an effective impact on psychological problems. It is important to consider the social and cultural background of a population for managing the stressors as an effective approach for preventing and reducing the destructive burden of psychological problems.

Invited Commentary: Preventable Pregnancy Loss Is a Public Health Problem

Pregnancy loss is common and can lead to long-standing parental depression and related problems. In this issue, a study of Danish registries by Bruckner et al. (Am J Epidemiol. 2016;183(8):701-708) correlates monthly trends in unemployment with monthly trends in reported spontaneous abortion, lagged by 1 month. The observed association might be caused by a general population phenomenon, as suggested by the authors, or might represent an increased miscarriage risk only within the subset of the population that is directly affected by lost income. Preventive interventions will vary depending on which interpretation is more likely. Research into the preventability of miscarriages and stillbirths is hampered in the United States by poor-quality vital registration of these events. Investment in improved surveillance systems is needed and would be worthwhile, as illustrated by the knowledge gained about the black/white gap in infant mortality when national birth and infant death records began to be linked. In addition, institution of the Pregnancy Risk Assessment Monitoring System in 1987 shed light on the association of stressful life events with poor birth outcomes. That system can be improved by sampling women who have experienced stillbirths. Better data would facilitate not only surveillance but also hypothesis-generating epidemiologic studies for identifying preventable pregnancy loss.

Relationships among Stress, Experiential Avoidance and Depression in Psychiatric Patients.

This study investigated the specific association of stressful life events (SLE) and experiential avoidance (EA) with depression in patients with mental disorders. It also analyzed the possible mediating role of depression in the relation of EA to well-being and life satisfaction. A total of 147 patients (mean age = 40.16 years) diagnosed with anxiety, mood or adjustment disorder were recruited from a mental health centre. They completed measures of SLE, EA, depression, well-being and life satisfaction. Regression analyses showed that SLE and EA were positively related to depression (R 2 = .45), although the contribution made by EA was higher (β = .61, p < .001) than the one made by SLE (β = .19, p < .01). Bootstrap mediation analyses revealed that there was an indirect effect from EA to physical well-being (B = -4.52, SE = .70, p < .001, 95% CI [-6.03, -3.20]) and satisfaction (B = -.14, SE = .02, p < .001, 95%, CI [-.19 -.09]) through depression. This indirect effect was less consistently supported with respect to emotional well-being (B = -3.33, SE = .48, p < .001, 95%, CI [-4.30, -2.41]). These findings give support to the hypothesis that EA could be an important factor contributing to depression in patients with mental disorders. The results also provide evidence that depression seems to play an important mediational role when considering the negative impact that EA exerts on patients´ well-being and satisfaction.

Association of stressful life events with accelerated bone loss in older men: the osteoporotic fractures in men (MrOS) study.

Prior studies suggest an association between stressful life events and fractures that may be mediated by BMD. In the current study, risk of accelerated hip BMD loss was higher in older men with any type of stressful life event and increased with the number of types of stressful life events. Prior studies suggest that stressful life events may increase adverse health outcomes, including falls and possibly fractures. The current study builds on these findings and examines whether stressful life events are associated with increased bone loss. Four thousand three hundred eighty-eight men aged ≥65 years in the Osteoporotic Fractures in Men study completed total hip bone mineral density (BMD) measures at baseline and visit 2, approximately 4.6 years later, and self-reported stressful life events data mid-way between baseline and visit 2, and at visit 2. We used linear regression to model the association of stressful life events with concurrent annualized total hip BMD loss, and log binomial regression or Poisson regression to model risk of concurrent accelerated BMD loss (>1 SD more than mean annualized change). Men (75.3 %) reported ≥1 type of stressful life event, including 43.3 % with ≥2 types of stressful life events. Mean annualized BMD loss was -0.36 % (SD 0.88), and 13.9 % of men were categorized with accelerated BMD loss (about 5.7 % or more total loss). Rate of annualized BMD loss increased with the number of types of stressful life events after adjustment for age (p < 0.001), but not after multivariable adjustment (p = 0.07). Multivariable-adjusted risk of accelerated BMD loss increased with the number of types of stressful life events (RR, 1.10 [95 % confidence interval (CI), 1.04-1.16]) per increase of one type of stressful life event). Fracture risk was not significantly different between stressful life event-accelerated bone loss subgroups (p = 0.08). In these older men, stressful life events were associated with a small, dose-related increase in risk of concurrent accelerated hip bone loss. Low frequency of fractures limited assessment of whether rapid bone loss mediates any association of stressful life events with incident fractures. Future studies are needed to confirm these findings and to investigate the mechanism that may underlie this association.

Associations of stressful life events and social strain with incident cardiovascular disease in the Women's Health Initiative.

BackgroundEpidemiologic studies have yielded mixed findings on the association of psychosocial stressors with cardiovascular disease (CVD) risk. In this study, we examined associations of stressful life events (SLE) and social strain with incident coronary heart disease (CHD) and stroke (overall, and for hemorrhagic and ischemic strokes) independent of sociodemographic characteristics, and we evaluated whether these relationships were explained by traditional behavioral and biological risk factors.Methods and ResultsData from approximately 82 000 Women's Health Initiative Observational Study participants were used for the SLE and social strain analyses, respectively. Participants were followed for events for up to 18.0 years (median, 14.0). Separate Cox proportional hazards models were generated to estimate associations of each stress measure with incident CVD. After adjusting for sociodemographic characteristics and depressive symptoms, higher SLE and social strain were associated with higher incident CHD and stroke (each P trend <0.05). Hazard ratios and 95% confidence intervals were 1.12 (1.01, 1.25) for incident CHD and 1.14 (1.01, 1.28) for incident stroke among participants reporting high versus low SLE. Findings were similar for social strain. Associations were attenuated with further adjustment for mediating behavioral and biological risk factors. Findings were similar for associations of SLE with ischemic stroke and hemorrhagic stroke, but social strain was only associated with ischemic stroke.ConclusionsHigher SLE and social strain were associated with higher incident CVD independent of sociodemographic factors and depressive symptoms, but not behavioral and biological risk factors.

Stressful life-events in childhood and risk of multiple sclerosis: a Danish nationwide cohort study

Background: Current knowledge concerning the association between exposure to stressful life-events (SFLEs) in childhood and later risk of multiple sclerosis (MS) is sparse. Objectives: We studied the associations between SFLEs in childhood and subsequent risk of MS in a nationwide cohort of 2.9 million Danes born from 1968 to 2011. Methods: A SFLE in childhood was defined as exposure before age 18 years to parental divorce, parental death, or death of a sibling, using information from the Danish Civil Registration System. MS cases in the cohort were identified in the Danish Multiple Sclerosis Registry. Associations of SFLE with MS risk were evaluated by incidence rate ratios (RR) of MS obtained in log-linear Poisson regression models. Results: Persons exposed to any SFLE in childhood were at 11% elevated risk of MS (RR = 1.11; 95% confidence interval: 1.03–1.20), compared to non-exposed persons. Stratification by subtype of SFLE showed that parental death and death of a sibling were not associated with MS risk. However, persons exposed to parental divorce were at 13% increased risk of developing MS compared to non-exposed (RR = 1.13; 1.04–1.23). Conclusions: Associations of SFLEs in childhood with risk of MS are weak. However, parental divorce is somehow associated with modestly increased risk of MS.

Association of stressful life events with incident falls and fractures in older men: the Osteoporotic Fractures in Men (MrOS) Study

small, retrospective studies suggest that major life events and/or sudden emotional stress may increase fall and fracture risk. The current study examines these associations prospectively. a total of 5,152 men aged ≥65 years in the Osteoporotic Fractures in Men study self-reported data on stressful life events for 1 year prior to study Visit 2. Incident falls and fractures were ascertained for 1 year after Visit 2. Fractures were centrally confirmed. a total of 2,932 (56.9%) men reported ≥1 type of stressful life event. In men with complete stressful life event, fall and covariate data (n = 3,949), any stressful life event was associated with a 33% increased risk of incident fall [relative risk (RR) 1.33, 95% confidence interval (CI) 1.19-1.49] and 68% increased risk of multiple falls (RR = 1.68, 95% CI = 1.40-2.01) in the year following Visit 2 after adjustment for age, education, Parkinson's disease, diabetes, stroke, instrumental activities of daily living (IADL) impairment, chair stand time, walk speed, multiple past falls, depressive symptoms and antidepressant use. Risk increased with the number of types of stressful life events. Though any stressful life event was associated with a 58% increased age-adjusted risk for incident fracture, this association was attenuated and no longer statistically significant after additional adjustment for total hip bone mineral density, fracture after age 50, Parkinson's disease, stroke and IADL impairment. in this cohort of older men, stressful life events significantly increased risk of incident falls independent of other explanatory variables, but did not independently increase incident fracture risk.

Stressful life events and asthma in adolescents

Recent studies suggest that psychosocial factors may contribute to asthma. We examined associations of stressful life events with asthma prevalence and morbidity among Chicago adolescents. Self-reported asthma, measures of asthma morbidity, and 15 life events were collected from 2026 seventh to ninth grade students from 34 Chicago Catholic schools as part of the International Study of Allergies and Asthma in Childhood in 1994-95. Life events were reported by 77% of adolescents and overall asthma prevalence was 15.5%. Stressful life events in adolescents were significantly related to both asthma and asthma morbidity. Odds of asthma was 1.44 (95% confidence interval [CI] = 1.07, 1.95) for those reporting two to three stressful events and 1.92 (95% CI = 1.41, 2.62) for subjects endorsing more than three stressful events. In adolescents with asthma, number of asthma symptoms (odds ratio [OR] for increase in one event = 1.16, 95% CI = 1.07, 1.27), asthma-related school absenteeism (OR = 1.17, 95% CI = 1.04, 1.32), physician visits for asthma (OR = 1.16, 95% CI = 1.04, 1.29), and hospitalization for asthma (OR = 1.20, 95% CI = 1.001, 1.44) were significantly associated with the number of stressful events, independent of home exposure to cigarette smoke and dampness, use of inhaled substances, and sociodemographic factors. While these results are not sufficient to assign causality in the relationship between stress and asthma, they are supported by a number of other studies and by plausible biologic mechanisms. Assessing and addressing the effects of stressful life events may be helpful in managing asthma in inner city adolescents.

The Influence of Stress on the Menstrual Cycle among Newly Incarcerated Women

We sought to estimate the association of stressful life events on menstrual function in incarcerated women. Project CONNECT is a study of reproductive health needs of incarcerated women conducted between June 2002 and December 2003. This analysis examines menstrual function in 446 women from this cohort who were under the age of 45. Regularity was defined as menses between 26 and 35 days long. Amenorrhea was defined as > or =90 days since last menstruation. Measures included stressful experiences and deprivation (e.g., physical or sexual abuse, stressful living conditions, exchanging sex for drugs or money, or having had an incarcerated parent). Menstrual dysfunction was common in this population. Nine percent reported amenorrhea, and 33% reported menstrual irregularity. A number of stressors were associated with menstrual irregularity, including having a parent with history of alcohol or drug problems (relative risk [RR] = 1.34; 95% confidence interval [CI], 1.00-1.80), childhood physical or sexual abuse (RR = 1.48; 95% CI, 1.03-2.13), or any sexual abuse (RR = 1.49; 95% CI, 1.03-2.14) after adjusting for age, race/ethnicity, smoking status, and recent drug use. These effects were attenuated somewhat when excluding women who had reported any hormonal contraceptive use in the past 3 months. Incarcerated women have high rates of amenorrhea and menstrual irregularity and the prevalence may be associated with certain stresses. Further research on the causes and consequences of menstrual dysfunction in this underserved population is needed.

Association of stressful life events with acute myocardial infarction in population in the city of Nis within the period from 1998-2000.

Stressful life events present a very important category of psychosocial stress. A few studies have showed that a psychosocial stress represents a very important risk factor for acute myocardial infarction (AMI), but measures of stress may not be suitable for different countries, cultures and ethnic groups. The aim of this study was to investigate the relation of stressful life events with AMI in the period of 1998-2000 in the population of the city of Nis. A case-control study included 100 patients with the first MI (in the period 1998-2000) and 100 healthy subjects, matched with respect to sex and age (+/- 2 years) from the city of Nis. The data of stressful life events were obtained by the Scaling of life events by Paykel ES, modified by the authors consistent with the examined population and the period of investigation. The Yates chi2 test, odds ratio - OR and their 99% interval of confidence were used as statistical procedures. The results showed that stressful life events in the period of investigation were very important risk factors for AMI with a statistically significant level (p = 0.000). Huge financial problems (OR = 202.36, Ci = 24.82-4387.58), violation of law (OR = 168.00, Ci = 10.66-6658.96) and serious illness of family members (OR = 159.60, Ci = 19.05- 3514.81) were the highest risk for AMI. The patients who reported that his/her son or other member of family had been gone to the army (or mobilization) before the illness onset, had 138 times higher risk of AMI (Ci = 14.98-3222.47, chi2 = 40.95, p = 0.000), while the patients who had mobilized themselves had 84 times higher risk (Ci = 7.00-2363.06, chi2= 23.87, p = 0.000). Effect of several stressful life events lead to significantly increased risk of AMI andthat significance is larger as the number of life events is more frequent (one life event: OR = 28.41, Ci = 3.73-593.52; chi2 = 17.40, p = 0.000; ? 4: OR = 336.00, Ci = 28.31-9760.28, chi2 = 50,43, p = 0,000). These findings indicate that stressful life events are associated with AMI and that they are very important for further epidemiological investigation of the triggering mechanisms and should improve preventive strategies of this serious disorder.